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29 May 2012

Roderick D. Buchanan's essay is both fascinating and informative, and it has really helped me to think about how personality inventories and projective tests worked together in modernity and postmodernity. As I was reading it, I took fairly extensive notes from the work. These may well interest regular readers. Where appropriate, I provide a bit of context. My comments below are in bold italics.

Buchanan begins his essay by setting up a comparison between the Rorschach Ink Blot Test and the Minnesota Multiphasic Personality Inventory (hereafter MMPI). While it is clear the Buchanan's past essays examined the emergence of the MMPI and the controversy it invited in the 1960s, this particular essay focuses on the question of how tools change as contexts change and how together tools and contexts produced successful diagnostic work in psychology (and I would add neurology and psychiatry too).

It is clear that Buchanan regards both tests as part-and-parcel of the story of postwar psychology's professionalization.

"Changing conceptions of the purpose and use of the MMPI and the Rorschach paralleled the changing context and charactersitics of clinical work since the Depression - from asylum to private practice, from test-artisan to psychotherapist. The MMPI proved enduringly useful in defining the changing professional identity of the clinical psychologist. MMPI researchers and users adjust to, and adjusted, the standards of empiricism developed in the academy and the new priorities of postwar clinical practice. (169)"

In the world post-Wündt, experimental psychology as a movement (think Titchner) began to dominate the American institutional structure of psychology in academia.

"Binet-type intelligence testing was the primary technology for marketing the practical capabilities of early American psychologists." (169)

And thus it was that applied psychologists and psychiatrists found themselves increasingly rivals in the medical landscape.

"Since the turn of the century, the mental hygiene movment had helped American psychiatrists overcome their traditional isolation as custodia caregivers in the state asylums. This, in turn, created opportunities for allied professional groups. Applied psychologists with an interest in learning and psychopathology - those beginning to define the emerge field of clinical psychology - found work in state mental hospitals, traning schools for the mentally defective, child guidance clinics, and psychoeducational clinics affiliated with schools and universities." (170)

Neurologists had mixed feelings about emergent clinical psychology.

"For Cornell neurologist Charles L. Dana, clinical psychologists were in much need "of an uplift and a delimitation of their good work." He caustioned his colleagues by asking whether this psychology might be, like a woman, a "desirable calamity". (171)

Curiously, it seems that the evident value of testing was not foreseen initially by clinical psychologists, who might well have protested remarks like those by Dana.

"Clinical psychologists, however, came to perceive the testing role as both second-rung and restrictive." (172)

Partly this was because the promises of "psychometrics" were not as clearly realized as many had hoped they would be. But soon psychological tests expanded and became more powerful.

"The earliest personality inventories were based on an extension of the intelligence testing model, though with certain important modifications." (173)

There perhaps most novel feature:-

"Like intellengence scales, these tests assumed that the important components of psychological functioning were present to some degree in all individuals; personality inventory items operationalized the measurement of these magnitudes. Item responses could then be combined to give an indication of an individual's tendency toward psychopathology or the strength of a personality attribute. Response totals were given meaning through comparison with a distribution of scores of a group of respondents."

And (this is very smart):-

"The personality inventories cosntructed two social worlds: one for the omniscient psychologist-tester and one for the passive, naive test "subject". No room for any negotiation of item meaning was envisaged; items had a fixed meaning understood by the psychologist and imposed upon the subject through the technology." (p. 174)

From here the essay moves towards exploring the objects of its comparison. First up: The Rorschach, which arrived in America in 1924.

"The respondent was interpreted as "projecting" his or her feelings, emotions, and underlying personality in response to the test stimulus. Individual differences in the style and content of responses were assumed to be a function of personality differences." (175)

The Rorschach quickly - albeit in limited fashion - found footholds in institutes and clinics. It also spawned imitators such as Henry Murray's TAT. It was marketed to biomedical and social science audiences. And it was critiqued in the late-interwar period for its lack of system and haphazard standards. The quote below suggests in fact that there was a Romantic component to the Rorschach.

"An interdependent mix of qualitative and quantitative data was blended together to form an overall psychodyamic intepretation. Rorschach testing contrasted sharply with traditional psychometrics, where numerical scores on linear scales were intepreted in comparison to population distribution. Additionally, the Rorschach was very open-ended: the ten stimulus cards allowed multiple response possibilities, within the constraints of the particular administrative framework employed. In sum, it was the antithesis of American psychometry." (176)

The Rorschach was easily applicable - it did not require high intellegence etc to participate in the test situation. In this sense, it was a means for overcoming the problem of the patient.

"For the test-taker, the Rorschach was less threatening and overtly evaluative than conventional tests and interviews; it was an enjoyable game for man, especially children." (177)

One fascinating feature was how the idea of technology and the Rorschach blended together.

"Psychologists touted the Rorschach as a kind of personality "X-ray," not for the first time borrowing a metaphor from medicine to describe (and legitimate) their work." (177)

Buchanan then turns to his second object of comparison, the MMPI, which was developed by Starke Hathaway and John McKinley. Interestingly, he claims without citation that:-

"Hathaway and McKinley used the local version of psychiatric classification to define scales, hoping that this would guarantee its relevance in day-to-day psychiatric work." (178)

In addition:

"Items that showed large frequency differentials were assembled in scales so as to maximize the separation between a diagnosis-specific psychiatric group and normal or psychiatric patients in general." (179)

The individual's responses to the questions mattered not at all, and:-

"Thus the actual content of the item was, for the purposes of scale construction, irrelevant. Only the aggregate pattern of responses to items was important for the purposes of scale construction." (179)

And:-

"The subjects would have little idea what their responses might mean. Again, psychologists had the final say on how test results should be intepreted." (179)

Subsequent years saw the MMPI popularized through chiefly military applications (although why this did not happen with the projective tests is something ignored here). However, the postwar institutionalization of psychology (and psychiatry and neurology) was enormous. What a difference a war had made!

"MMPI research and use during and just after the war took place amid these changes in the mental health field and displayed a transitional instability. Attempts to corroborate or predict psychiatric diagnoses with the MMPI, Hathaway and McKinley's original goal, were only moderately successful. In these terms the test "failed". The MMPI had promised enhanced professional legitimacy for psychologists but used biomedical psychiatry as the scientific yardstick and dominant professional model." (181-82).

Indeed:-

"The MMPI's debt to psychiatry was written off as clinical psychologists began to outline a more distinctive professional and intellectual agenda. Outspoken criticism of psychiatric diagnosis had been almost unthinkabout for clinical psychologists prior to the war; in the postwar years, it became commonplace." (182)

Hathaway, with another collaborator, created an atlas that made MMPI intepretation easier. It set out to match types with MMPI codes.

"Despite the medical legacy of its construction, despite an item content that leaned heavily toward somatic symptomatology, the MMPI was demedicalized. Instead, it was now conceived as a measure of psychological character." (p. 183)

And the MMPI became very popular:-

"Use of the MMPI quickly spread westward, but eastward with the same momentum. Few Minnesota clinical graduates obtained positions in the East after the war. Lacking such personal sponsorship, the MMPI was virtually excluded from Ivy League schools in the 1950s." (184)

In this way, the MMPI became a tool by which psychology began to standardize its clinical practices. Statistics were especially important in that process. In addition:-

"Higher qualification levels and sheer numbers had given clinical psychologists a sense of legitimacy and power that backed a more aggressive marketing of their services." (p. 189)

Buchanan argues that partly this was the case because the MMPI was more efficient than the Rorschach. I'm not sure that I agree on this point.

"The MMPI had the advantage of being far more labor efficient for the clinical psychologist than rival projective tests, particularly the Rorschach. The MMPI was lengthy, with many scoring and interpretive peculiarities. However, the development of booklet format and machine scoring made sure that giving the test taxed only the goodwill of test respondents." (190-91)

By contrast:-

"Although labor time for the total testing service would vary, administering, scoring, and interpreting a single Rorschach might take up to four or five hours of the clinician's time. This was far longer than would usually be the case with the MMPI." (192)

Buchanan concludes his article with the following observation:

"The contrasting stories of the MMPI and Rorschach offer compelling examples of the co-production of tool and context. The MMPI initially reflected the subordinate position of psychologists' prewar hospital work. As clinical psychologists made a self-conscious break from a medically-defined identity and model of mental maladjustment, the test was reinterpreted accordingly. The easy administration and scoring the MMPI, and the formalized strategies developed for its interpretation, promised and delivered a labor-efficient package." (p. 193)

Whither the Rorschach?

"As academia became more crucial for the teaching of testing, the "unscientific" tag stuck." (194)